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General NPI Number Information
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NPI Number | 1215497557
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Entity Type | Individual
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Provider Name | MARIAM RATIANI MD
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Gender | Female
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Dates
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Enumeration Date | 03/22/2019
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 5705 NE 11TH AVE
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City | PORTLAND
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State | OR
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Zip | 97211-4203
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Country | US
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Telephone | 585-481-0052
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Fax |
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Provider Business Mailing Address
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Address Line | 5705 NE 11TH AVE
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City | PORTLAND
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State | OR
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Zip | 97211-4203
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Country | US
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Telephone | 585-481-0052
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | MD218296
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License Number State | OR
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